摘要
应用立体定向手术技术与伽玛刀结合治疗颅内病变患者 5 5例 ,其中男 33例 ,女 2 2例 ,年龄 12～ 72岁 ,平均 41岁。病变部位 :鞍区 2 1例 ,大脑半球 10例 ,基底节区 9例 ,小脑半球 5例 ,脑干 4例 ,多发 6例。治疗方式为立体定向活检和 (或 )囊腔穿刺抽吸囊液 +伽玛刀治疗。结果 47例活检中 44例获得明确的病理诊断 ,阳性活检率为 93.6 %。囊腔穿刺抽出囊液 1～ 30ml,穿刺后症状明显缓解。无严重并发症和手术死亡。说明该联合治疗技术可在病人接受伽玛刀治疗的同时做出病理学诊断 ,利于治疗计划的制定和预后判断 ;囊腔穿刺可迅速降低颅内压力 ,改善病人症状 ,减少病变体积及周围脑组织放射性损伤 ,扩大了伽玛刀治疗适应症 。
Fifty-five patients with brain lesions were treated with gamma knife combined with stereotaxic technique. There were 33 males and 22 females, and their age ranged from 12 to 72, averaged 41 years. The lesions were located in the sellar area in 21 patients, in the deep cerebrum in 10,in the basal ganglion in 9, in the cerebellum in 5, in the brain stem in 4. Intracranial multiple lesions were found in 6 patients. Twenty-four patients were treated with gamma knife combined with stereotaxic biopsy, 21 with gamma knife combined with stereotaxic aspiration for the cyst and 8 with gamma knife combined with stereotaxic biopsy and aspiration. In the other 2 cases, conservative therapy was used because their pathogenesis was parasite and abscess. Of the 47 biopsies, glioms were diagnosed pathologically in 15 cases, metastasis in 9, craniopharyngioma in 7, pituitary adenoma in 4, germinoma in 3, other tumor in 4, parasite in 1 and abscess in 1. The biopsy positive rate was 93.6%. Aspirated cytic fluid ranged from 1 to 30ml, and the symptoms improved dramatically after aspiration. There were no severe complications and deaths related to stereotaxic procedures. It suggested that gamma knife combined stereotaxic technique is a useful and safe procedure for neuropathological diagnosis and an appropriate management for certain brain lesions.
出处
《解放军医学杂志》
CAS
CSCD
北大核心
2001年第4期288-290,共3页
Medical Journal of Chinese People's Liberation Army
